How Tana family’s search for ICU bed ended up in death 488km away

A 67-year-old man lost the battle for his life last Friday because Tana River County, where he had undergone successful surgery, does not have intensive care facilities.

When Hussein Hassan collapsed in his house, every second was crucial for his survival but the only help his family received was in Tharaka Nithi County.

PCEA Chogoria Hospital, some 488km from Hola, is seven hours by road. But he did not make it and died on the way.

His family said Mzee Hassan had developed a growth in his stomach that emerged months after he had undergone the first operation 11 months earlier.

"He collapsed at around 8pm and we rushed him to Hola Referral Hospital, where he underwent an operation," recounted Hassan’s brother Abdi.

The second operation was successful but doctors realised that the patient was still in critical condition, and to help him recover he had to be placed in the Intensive Care Unit (ICU).

But Hola Referral has no ICU equipment nor does such a facility exist, so they had to refer the patient as an emergency case.

Critical condition

"They called all the hospitals in the region looking for an ICU space, but none had any space as all the ICUs were filled. This is until the doctor made a call to a friend in Chogoria Hospital who found a functional ICU,” Mr Abdi narrated.

It took the family more than six hours to find help and they were provided with an ambulance and an oxygen tank.

The journey on the rough road bore a lot of uncertainty and with a patient in critical condition, they could only pray for his life.

“It was a drive like no other. He ran out of oxygen when we arrived in Matuu, and we got in touch with Matuu Hospital in Machakos County. We were grateful as they gave us a fully equipped ambulance and a driver to head to Tharaka Nithi," said Mr Abdi.

But in Embu County, just a few minutes to their destination, Hassan used the little strength left in him to grab his brother's hand as a sign of farewell before he died. 

The nurse who had accompanied them confirmed the death. The driver then slowed down the vehicle to a stop, and together mourned with the family before they embarked on the journey back home.

"We felt so bad. We know that the doctors from the county did their job very well, but the county administration is to blame for this death," said Mr Harun Hassan, another brother of the deceased.

Proper facilities

Mr Harun said the expenses they incurred could have been cut if only county administration had lived up to responsibilities.

An equipped referral hospital with proper facilities is just one of the promises made by successive leaders when they took over.

Hassan’s death has provoked questions on the whereabouts of money sent by the national government to counties to set up ICU facilities after Covid-19 struck.

Tana River received more than Sh38 million of the share. The county government announced plans to build an ICU but later replaced it with plans to build a High Dependency Unit.

However, no such facility exists, and nor are visible plans to set up one.

An ICU bed – including supporting equipment such as monitors for assessing patients’ wellbeing, defibrillators for resuscitation and ventilators for helping patients to breathe – costs at least Sh8 million.

HDUs are wards for people who need more intensive observation, treatment and nursing care than is possible in a general ward but slightly less than that in the ICU.

No ICU specialists

Specialised healthcare workers such as physicians, nurses and cardiologists are also vital.

"Instead of getting services in our hospitals at home, we are forced to raise more than Sh300,000 to get an ICU in Mombasa, Malindi, or other neighbouring counties," said Mr Daud Dahir, an activist.

Yesterday, Tana River Health Executive Javan Bonaya noted that the county has no specialists for the ICU department.

"We don't have those experts, and also in as much as we may need the ICU, the demands in having one running vis-à-vis the cases we receive that require such a facility disqualifies it for a priority," he said.

Nevertheless, he said, the county will advertise a tender for construction of an HDU this month, noting that the plans had been stuck in the procurement process and passing of a supplementary budget

He said setting up the HDU will begin this year, urging residents to be patient.

"We must admit that there are problems we are yet to resolve, and we can’t settle them within the three years we have had but we have the solutions in the plan," he said.

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